New diagnostic definition of myocardial infarction issued

August 28, 2012

An updated universal definition of myocardial infarction includes detection of a rise and/or fall in cardiac biomarker values, preferably cardiac troponin, according to a statement published online Aug. 26 in Circulation to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

(HealthDay)—An updated universal definition of myocardial infarction (MI) includes detection of a rise and/or fall in cardiac biomarker values, preferably cardiac troponin (cTn), according to a statement published online Aug. 26 in Circulation to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

Kristian Thygesen, Ph.D., from the Aarhus University Hospital in Denmark, and colleagues on the Joint European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Heart Federation Task Force for the Universal Definition of Myocardial Infarction created the revised definition to be used to better diagnose patients and define clinical trial end points.

The Joint Task Force defined an acute MI as evidence of myocardial necrosis consistent with acute myocardial ischemia. In this case, the criteria for MI are met with detection of a rise and/or fall of cardiac biomarker values, ideally cTn, with one or more value above the 99th percentile upper reference limit, in conjunction with at least one of the following: symptoms of ischemia; new or presumed new significant ST-segment-T wave changes or new left bundle branch block; development of pathologic Q waves; imaging evidence of new loss of myocardium or abnormality of regional wall motion; or identification of an intracoronary thrombus. In addition, specific criteria are provided for percutaneous coronary intervention-, stent thrombosis-, and coronary artery bypass grafting-related MIs.

"This is a truly global document that will be used worldwide," Thygesen said in a statement. "It will help doctors diagnose their patients so that they can provide the most appropriate treatment, and help researchers design clinical trials with standardized end points."

Several Task Force members and additional contributors disclosed financial ties to the pharmaceutical and biomedical industries.

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